CPS Splenomegaly

Question 1

overall causes of splenomegaly

Answer 1

1. congestive (cirrhosis, thrombus due to PE)
2. infectious (parasite (malaris), viral (EBV, HIV, CMV, Hepatitis)
3. Infiltrative (maligant or benign)
4. inflammatory (sarcoid)
5. hemolytic (ss, thalessemia)

Question 2

cause of splenomegaly?

Answer 2

ITP = autoimmune disease where Abs are formed against your own platelets

Hb= anemic

Plt= low. probably due to ITP.

ALP is high, GGt is high so it is due to liver.

LDH = 100, high?

INR is higher = bleeidng. Bilirubin= highish.

obese = ALP high due to fatty liver?

Splenomegaly due to hemolysis or congestive (hypertension, obestiy, fatty liver).

Question 3

cause of splenomegaly?

Answer 3

anemia and jaundice = indications of hemolysis

alp is a bit higher, LDH is very high = hemolysis

bilirubin is high (direct is 10), thereofre indirect is 40 (unconjugated)– not a liver issue, there’s either too much RBC production or bleeding is happening.

• inr normal = no clotting issue.

cause is due to hemolytic disase. (this person was found to have hereditary spherocytosis with dat -)

Question 4

cause of splenomegaly?

Answer 4

lymphadenopathy and splenomegaly – the lymphnode issue indicates to me that immune function is involved: could be reactive or malignancy.

sore throat and fever– more so reactive lymphocytosis

• alt and ast high, alp is high= elevated cholestatic liver enzymes. gall stone, autoimmune, alcoholic hepatitis, PBS, PBC etc.

LDH is normal = no bleeding.

Bilirubin is a bit high. albumin is hgih.

If her brother has a sore throat, i would think that splenomegaly is due to infectious causes like EBV.

- later on, her slide showed atypical lymphocytes, characeristic of EBV or other viral infections.

Question 5

cause of splenomegaly?

Answer 5

rheumatoid arthritis= autoimmune issue

NSAIDS and methotrexate.– nsaids can cause coagulopathies

anemic, normocytic, platelets are normal thoguh.

she probably has anemia of chronic disease.

bilirubin is normal i think.

splenomegaly due to inflammatory cause. (felty’s disease)

Question 6

felty’s syndrome is an ____ cause of splenomeagly that is seen in patients suffering from autoimmune ___ ___. What’s the triad?

Answer 6

inflammatory cause of splenomaly. seen in patients with rheumatoid arthritis

triad of:

1. rheumatoid arthritis
2. splenomegaly
3. low WBC.

may also be relatd to nodular regenerative hyperplasia and non-cirrhotic portal hypertension.

Question 7

cause of splenomegaly?

Answer 7

poor growth and developemnet, pallor, jaundice and distended abdoment– parasitic infection? hemolysis? he could have sickle cell anemia–> consistent with consanguity

• high bilirubin – bleeding. low haptoglobin– consistent with hemolyiss.

frontal bossing– consistent with thalassemia!!

splenomegaly due to hemolystic disease. this kid was later diagnosed with thalassemia

Question 8

cause of splenomegaly?

Answer 8

this guy was previously healthy until 2 months ago, when he started getting a shortness of breath– acquired issue.

drenching night sweats,weightloss – malignancy.specifically lymphocytosis.

anemic, normocytic, wbc normal. Anemia could be due to bone marrow probelm?

ALP is high – cholestatic. infiltrative diseases can cause ALP increases.

this guy has splenomegaly due to infiltrative causes. probably a lymphocytosis/lymphoma/leukemia/tumors.

Question 9

pre, intra, and post hepatic causes of non-cirrhotic portal htn

Answer 9

pre: portal vein thrombosis, splenomegaly

intra hepatic: schisotomiases, PBC, sarcoidosis, nodular regnerative hyperplasia, budd-chiari syndrome

post hepatic: IVC obstruction, cardiac disease.